CARAMEL: Retrospective Study for Personalized Risk Assessment of Cardiovascular Disease in Menopausal and Perimenopausal Women Using Real World Data

NCT ID: NCT06999317

Last Updated: 2025-05-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

1500000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-07-01

Study Completion Date

2026-06-30

Brief Summary

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This retrospective observational study, part of the EU-funded CARAMEL project, aims to develop and validate personalized cardiovascular disease (CVD) risk assessment models specifically designed for menopausal and perimenopausal women (ages 40-60). The study leverages Real World Data (RWD) collected from multiple international clinical partners, including electronic health records (EHR), diagnostic imaging data, and signal data.

The main objective is to improve the prediction of CVD precursors such as hypertension and dyslipidemia, as well as mid- and long-term risk of CVD events, through advanced artificial intelligence (AI) models. These models will be trained on multimodal data to capture complex, individualized risk trajectories that current risk calculators fail to address, particularly in women. Special focus is placed on under-researched, women-specific risk factors and their interactions with traditional predictors.

The study includes several research objectives: (1) predicting the onset of hypertension and dyslipidemia using EHR data; (2) modeling the long-term risk of fatal and non-fatal cardiovascular events and disease trajectories; (3) identifying novel imaging biomarkers from routine screening tests such as mammography, DXA, ultrasound, and cardiac MRI; (4) developing multimodal prediction models combining imaging and clinical data; (5) creating automated AI tools for imaging biomarker extraction; and (6) using signal data from cardiac devices to predict disease progression and events.

The study population consists of middle-aged women with retrospective data available across different health systems. The expected outcome is a validated set of stratified, personalized CVD risk models that can support targeted prevention strategies and enable more equitable, sex-specific care. This will contribute to reducing the burden of CVD in women and addressing critical gaps in early detection, clinical decision-making, and health policy.

This project has received funding from the European Union's Horizon Europe Research and Innovation Programme under Grant Agreement No 101156210.

Detailed Description

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Conditions

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Cardiovascular Risk Factors Menopausal Women Perimenopausal Women Real World Data

Keywords

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Cardiovascular Disease Cardiovascular risk factors Menopausal women Perimenopausal women real world data personalised prevention computational modelling women-specific risks

Study Design

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Observational Model Type

OTHER

Study Time Perspective

RETROSPECTIVE

Study Groups

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ASCIRES IMAGE DATABASE

Digital imaging biobank 10y long from several manufact 1,000 cMRI; 500 cardiac CT; 500 coronary artery calcification; 1,000 DXA From women 40- 60y urers / modalities

No interventions assigned to this group

Basque Health Service Database

Longitudinal EHR data up to 15y including diagnosis, procedures, prescriptions, lab tests, visits, imaging, etc.

\~128,00 women 40-60 14,880 DM, 3,124 DXA, 332 carotid US

No interventions assigned to this group

Clalit Primary Prevention Database

Manually curated DB of structured EHR data

\~750,000 middleaged women

No interventions assigned to this group

Irish Implant Devices Registry

Irish Implant Devices Registry (REG) (HRI) 15y of data for implant procedures and follow-ups (pacemakers, ICD's, loop recorders)

\~85,000 implant (pacemaker) proced ures \~700,000 follow-up w. indications \& diagnosis

No interventions assigned to this group

Keralty Colombia Database

EHR data from primary/specialised care centres. Longitudinal EHR data up to 5-10y Including diagnosis, procedures, prescriptions, lab tests, visits, etc.

\~85,593 women 40-60y \~25,000 women with CVD problems

No interventions assigned to this group

Andalusian Health Population Database & Macarena University Hospital EHR

Longitudinal EHR data up to 15y including diagnosis, clinical procedures, prescriptions, lab tests, visits, etc. The hospital Dataset is OMOP CMD mapped

\~700,000 middleaged women

No interventions assigned to this group

Lithuanian High Cardiovascular Risk (LitHiR) primary prevention programme database

EHR data from primary cardiovascular prevention programme in VULSK (1 centre). Data including demographics, risk factors, lab tests (including lipid profile, renal function, etc.), arterial markers (pulse wave velocity analysis data; CardioAngle Vascular Index data; carotid artery intimamedia thickness data).

Some patients have 5-10y longitudinal data with outcomes.

\~6000 women 40-65y with high - very high cardiovascular risk, but without overt CVD;

No interventions assigned to this group

National and Kapodistrian University of Athens Database - Aretaieion Hospital

EHR data from Menopause clinic of Aretaieion university hospital including blood tests, medication, prescriptions, visits

\~4000 middle aged women

No interventions assigned to this group

CoroPrevention - Tampere University (TAU)

Pan-European (25 sites) contemporary prospective CVD prevention cohort from ongoing HEU project it includes clinical data, 3-year CV event data, lifestyle, RFs. Standard + CVD biomarkers (CERT2, hsTNI, NTproBNP, Cystatin C…) N=\~3,000 women (subsample of whole cohort)

No interventions assigned to this group

AKRIBEA - Cooperative Research Centre for Biosciences Association (CIC)

Non-oriented 7y follow-up cohort from Basque Country Region. Urine+serum biomarkers and metabolome; serum lipoproteins by NMR; demographics \& RFs N=\~ 2,500 women (40 to 60 y)

No interventions assigned to this group

MENO - Cooperative Research Centre for Biosciences Association (CIC)

Pre- and post-menopausal women cohort from Basque Country Region. Urine+serum biomarkers and metabolome; serum lipoproteins by NMR; demographics \& RFs N =\~ 1,700 women

No interventions assigned to this group

UK Biobank - UK Biobank

Largest geno-phenotype-rich population-based study in the world (500K), includes multi-modal imaging data (60K) and eye and vision (67K), biomarkers, demographic data, lifestyle (100K with wearables) and health outcomes.

Middle-aged women among:

* 500K baseline
* 60K imaging study
* 67K retina \& OCT

No interventions assigned to this group

Qatar Biobank

Population-based with annotated data, biological samples, tests and imaging for 60K participants. It includes Demographics data, lifestyle, biomarkers, weight \& body fat, hip\&waist, BP, ECG, carotid US, full-body MRI, retinography, DXA Middle-aged women among \~60K total participants

No interventions assigned to this group

International Agency for Research on Cancer (IARC) / EPIC-Europa

Long-term European population-based cohort (520K participants across 10 countries). Includes clinical data, anthropometric measurements, demographic, lifestyle, dietary habits, and socioeconomic data, reproductive history, and biological samples such as serum, plasma and DNA for biochemical data and genotyping data N = \~367k women between 35 to 65 years old (subsample of whole cohort)

\~65k CVD cases across the full cohort

No interventions assigned to this group

ILERVAS -Institute for Research in Biomedicine IRB Lleida

Interventional longitudinal study that includes detailed assessments of subclinical atheromatosis in 12 vascular territories using ultrasound, along with clinical, anthropometric, lifestyle, dietary, and biochemical data.

N = \~4165 women (50 to 70y) (subsample of whole cohort)

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

Self-identified as female in the electronic health record (EHR). Age between 40 and 60 years at the time of data collection/index date. Availability of at least 5-6 years of retrospective data in the EHR, depending on the research objective.

At least one healthcare encounter (visit, imaging, lab test, diagnosis, etc.) within the defined age range.

For imaging substudies (e.g., RO3-RO5): availability of at least one relevant imaging test (e.g., DXA, digital mammography, cMRI, CCTA, US) during the age range.

For signal-based analysis (RO6): presence of ECG monitoring data from implanted devices and at least 2 years of follow-up.

Exclusion Criteria

Prior diagnosis of cardiovascular disease before the observation window (only applicable to specific ROs, e.g., RO2, RO4).

Insufficient data quality or missing key variables needed for modeling (e.g., absence of blood pressure or lipid profile).

Patients with incomplete or inconsistent records (e.g., duplicate IDs, mismatched time frames).

For signal-based RO6: hospitalizations or diagnoses unrelated to cardiovascular health that may bias AI model training.
Minimum Eligible Age

40 Years

Maximum Eligible Age

60 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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VISUAL INTERACTION & COMMUNICATION TECHNOLOGIES - VICOMTECH

UNKNOWN

Sponsor Role collaborator

Clinic for Cardiovascular Diseases Magdalena

NETWORK

Sponsor Role collaborator

Biokeralty Research Institute

INDUSTRY

Sponsor Role collaborator

Keralty SAS. Colombia

OTHER

Sponsor Role collaborator

ETHNIKO KAI KAPODISTRIAKO PANEPISTIMIO ATHINON

UNKNOWN

Sponsor Role collaborator

Fundación Pública Andaluza para la gestión de la Investigación en Sevilla

OTHER

Sponsor Role collaborator

University of Dublin, Trinity College

OTHER

Sponsor Role collaborator

TREE Technology S.A.

UNKNOWN

Sponsor Role collaborator

Dublin City University

OTHER

Sponsor Role collaborator

Tampere University

OTHER

Sponsor Role collaborator

Ben-Gurion University of the Negev

OTHER

Sponsor Role collaborator

Biogipuzkoa Health Research Institute

OTHER

Sponsor Role collaborator

Vilnius University Hospital Santaros Klinikos

OTHER

Sponsor Role collaborator

Hospital Universitario Virgen Macarena

OTHER

Sponsor Role lead

Responsible Party

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Luis Gabriel Luque Romero

Head of Primary Care Clinical Research Unit

Responsibility Role PRINCIPAL_INVESTIGATOR

Other Identifiers

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CARAMEL RS

Identifier Type: -

Identifier Source: org_study_id